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Prior to lumpectomy, the doctor usually physically examines the patient and performs a mammogram, which is an x-ray film of the breast's soft tissue. The doctor usually performs a fine-needle biopsy of the breast and takes blood and urine samples for testing. If the tumor is not palpable (cannot be located by touch), the doctor usually performs a wire-localization procedure, which involves a fine wire, or similar tool, along with an x-ray film or ultrasound to confirm the tumor's location.

The preparations for a lumpectomy are routine for a typical surgery. The doctor may ask the woman about any medications or supplements she may be taking. The doctor usually advises the woman not to eat or to drink anything for at least 8-12 hours before the surgery. The doctor usually discusses what to expect during and after surgery. This may include what sensations she may feel during the surgery, what type of anesthesia will be used, and what to expect following the procedure.

Immediately before the procedure, the woman receives either (1) a local anesthetic (medication that numbs only the breast and nearby tissues) with sedation or (2) general anesthesia (medication that induces unconsciousness). Which type of anesthesia the woman receives usually depends on how extensive the doctor expects the surgery to be. Most women receive general anesthesia, which involves inserting intravenous lines to provide fluids and an oxygen tube that runs down her throat.

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